The Value of Rapid Reviews

Purpose: The Radiological Physics Center (RPC) performs rapid reviews for several different study groups and for a variety of disease sites including colon, breast, endometrial and cervix. Rapid Reviews have been performed for high dose rate brachytherapy studies, 3D CRT and IMRT studies. The purpose of rapid reviews is to verify that the radiation oncologist is capable of treating a patient per protocol prior to treatment commencing with the goal of reducing the number of deviations.

Methods:The rapid review process requires that the institution electronically submit the protocol patient treatment plan prior to the commencement of treatment for a dosimetric and clinical review. Dependent on the protocol, the first patient or every patient submitted by a physician might require a rapid review. Rapid reviews enable the RPC to provide feedback to the physician to rectify errors prior to the start of treatment. Deviations are assessed according to defined criteria within the specific protocol

Results:For three protocols, where rapid reviews were required for the first patient placed on protocol, 24%, 48% and 53% required a revision and resubmission for a re-review due to a significant protocol deviation. For one protocol, where rapid reviews were required for all patients, 81% of the submitted patient cases required a revision and resubmission for a re-review. Radiation Oncologists who completed the rapid review process received no major deviations on subsequent patient's placed on protocol.

Conclusion:Rapid reviews serve the purpose of reducing the number of protocol deviations by providing feedback to Radiation Oncologists on how to better comply with the requirements of the protocol prior to commencing treatment of a patient on the study.

This work was supported by PHS grants CA10953 and CA081647 awarded by NCI, DHHS.

Funding Support, Disclosures, and Conflict of Interest: This work was supported by PHS grants CA10953 and CA081647 awarded by NCI, DHHS.